How to Improve the Maternal Pathway for Migrant Women: Insights for Retention Strategies from Tuscany Region

Despite the structural presence of migrants in Italy since several years, inequalities affect the migrant population, especially regarding the access to public healthcare services and use of all the opportunities for health. Maternal healthcare is a key area on which exploring different patterns in use of prenatal services among migrant and Italian women, along a multi-touchpoint pathway. This study aims to analyse these patterns and to identify specific determinants of maternal services’ use in the first phases of the women journey, and, in particular, the attendance to antenatal classes of migrant women and main motivations for their not participation. It also verifies different perceptions of antenatal classes’ utility among migrant and Italian women who attended them. The observational study used different sources of data routinely recorded by Local Health Authorities or collected through surveys addressing health services users in Tuscany Region, Italy. Secondary analysis with descriptive statistics, chi-squared tests and multivariate logistic regression models were performed using the above-mentioned data. Findings show that migrant women access to family care centres during pregnancy for prenatal visits more than Italian women, but they less attend antenatal classes organised by the same providers. Migrant women represent a group of «acquired users» of family care centres’ services at the first touchpoints who are mainly unretained and are currently defected for other services along their journey. Moreover, the results of this study show that migrant women are mostly not attending valuable services that other migrant women experienced and perceived as useful. In light of these findings, possible appropriate strategies to improve the participation of migrant women to antenatal classes and their loyalty along the maternal pathway were presented and discussed. Innovative retention strategies should be based on a careful vision ofthe whole journey and a segmentation of potential and actual users. Those activities can inform the customisation of services, improve communication,increase women’s understanding of maternal care provision and re-organise antenatal classes according to women’s needs and preferences.